Sometimes patients present to their GP practice describing problems that might be symptomatic of sexually transmitted infections (STIs) such as chlamydia or gonorrhoea.

Pathology Services across Hampshire, Southampton and Portsmouth, now use nucleic acid amplification tests (NAATs) which simultaneously detect for both chlamydia and gonorrhoea (dual NAATs). Therefore standard practice in this situation would be for primary care staff to sample such patients using a NAATs test for both chlamydia and gonorrhoea.

Local laboratories are now set up to dual NAATS and so testing only for chlamydia and not gonorrhoea can create a problem; as the gonorrhoea result is suppressed from the tester. Not requesting testing for both STIs may cause preventable harm to the patient through delay in treatment of an infection that the GP and patient are unaware of, but which the laboratory did detect. There is also the risk of onward transmission which would be preventable if appropriate screening had been undertaken initially.

To prevent this risk we are advising that when referring a patient for testing for chlamydia or gonorrhoea, patients should be advised that the single urine test involved would detect either. Best practice would suggest that dual testing should be undertaken as standard in all patients presenting for screening (particularly those who are symptomatic).

Where the patient presents as a contact of a confirmed gonorrhoea case they should be offered the NAATs test and have cultures carried out for sensitivities. If the diagnosis is confirmed, they can be referred to the sexual health service for treatment and partner notification as required.

Please note that the above should not be taken to mean that the sexual health service is encouraging or diverting patients with suspected STIs to attend GPs. This advice is intended only to improve consistency for those patients who have chosen to attend a GP appointment in relation to a condition that may have an underlying STI cause.